1 Data

1.1 baseline

Patient’s Baseline Characteristics
level 1 ROBOT 2 LPS+LESS p test SMD
n 478 1539
ECOG (%) 0 無症狀 248 (51.9) 608 (39.5) <0.001 0.521
1 有症狀,可步行對生活不影響 187 (39.1) 534 (34.7)
2 躺在床上時間小於50% 21 ( 4.4) 81 ( 5.3)
3 躺在床上時間大於50% 3 ( 0.6) 9 ( 0.6)
4 完全臥床 0 ( 0.0) 4 ( 0.3)
NA 19 ( 4.0) 303 (19.7)
性別 (%) 1 男 202 (42.3) 633 (41.1) 0.701 0.023
2 女 276 (57.7) 906 (58.9)
BMI (%) Normal 227 (47.5) 581 (37.8) <0.001 0.318
Overweight 133 (27.8) 353 (22.9)
NA 118 (24.7) 605 (39.3)
診斷年紀 (mean (SD)) 69.29 (10.24) 68.74 (10.48) 0.317 0.053
Cell_Type (%) 1 urothelial 413 (86.4) 1385 (90.0) 0.076 0.114
5 UC with variants (Squamous cell, glandular, sarcomatous, micro papillary, neuroendocrine, lymphoepithelial) 61 (12.8) 147 ( 9.6)
6 others 4 ( 0.8) 7 ( 0.5)
左右側 (%) 1 左 248 (51.9) 800 (52.0) 0.988 0.008
2 右 223 (46.7) 715 (46.5)
3 雙側 7 ( 1.5) 24 ( 1.6)
腫瘤位置 (%) 0 non-visible 1 ( 0.2) 1 ( 0.1) NaN 0.101
1 腎盂 186 (38.9) 652 (42.4)
2 輸尿管 175 (36.6) 499 (32.4)
3 膀胱袖口 1 ( 0.2) 2 ( 0.1)
4 多個位置 115 (24.1) 385 (25.0)
5 無法識別 0 ( 0.0) 0 ( 0.0)
多發性 (%) 0 Not available 18 ( 3.8) 90 ( 5.8) 0.209 0.098
1 No 295 (61.7) 933 (60.6)
2 Yes 165 (34.5) 516 (33.5)
腫瘤大小 (%) 0 Not available 7 ( 1.5) 55 ( 3.6) 0.057 0.138
1 <2cm 152 (31.8) 460 (29.9)
2 >=2cm 319 (66.7) 1024 (66.5)
病理分期 (%) 1 stage 0a/0is 73 (15.3) 241 (15.7) 0.015 0.188
2 stage I 118 (24.7) 434 (28.2)
3 stage II 79 (16.5) 296 (19.2)
4 stage III 144 (30.1) 442 (28.7)
5 stage IV 52 (10.9) 106 ( 6.9)
NA 12 ( 2.5) 20 ( 1.3)
完整檢體腫瘤惡性度 (%) 1 papillary urothelial neoplasm of low malignant potential 1 ( 0.2) 1 ( 0.1) 0.190 0.123
2 low grade 47 ( 9.8) 139 ( 9.0)
3 high grade 418 (87.4) 1369 (89.0)
4 Gx 2 ( 0.4) 15 ( 1.0)
NA 10 ( 2.1) 15 ( 1.0)
合併膀胱腫瘤 (%) 0 No 355 (74.3) 1072 (69.7) 0.092 0.160
1 Previous Hx of bladder UC 33 ( 6.9) 114 ( 7.4)
2 Concurrent Bladder UC 70 (14.6) 261 (17.0)
3 Not available 14 ( 2.9) 41 ( 2.7)
NA 6 ( 1.3) 51 ( 3.3)
合併CIS (%) 0 No 323 (67.6) 1057 (68.7) 0.096 0.121
1 Yes 148 (31.0) 434 (28.2)
NA 7 ( 1.5) 48 ( 3.1)
Lymphovascular_invasion (%) 0 No 365 (76.4) 1254 (81.5) <0.001 0.195
1 Yes 92 (19.2) 264 (17.2)
NA 21 ( 4.4) 21 ( 1.4)
surgical_margin (%) 0 free 448 (93.7) 1469 (95.5) 0.085 0.110
1 positive 26 ( 5.4) 51 ( 3.3)
NA 4 ( 0.8) 19 ( 1.2)
術前水腎 (%) 1 No 207 (43.3) 715 (46.5) 0.151 0.104
2 Yes 257 (53.8) 759 (49.3)
NA 14 ( 2.9) 65 ( 4.2)
Tumor_Necrosis (%) 0 No 411 (86.0) 1131 (73.5) <0.001 0.433
1 Yes 57 (11.9) 208 (13.5)
NA 10 ( 2.1) 200 (13.0)
有無針對UTUC化療 (%) 0 No 321 (67.2) 1071 (69.6) 0.020 0.154
1 Yes 147 (30.8) 402 (26.1)
2 Not available 10 ( 2.1) 66 ( 4.3)
針對UTUC化療型態 (%) 0 No & Unknown 331 (69.2) 1135 (73.7) 0.011 0.172
1 neo-adjuvant 19 ( 4.0) 42 ( 2.7)
2 adjuvant 92 (19.2) 296 (19.2)
3 salvage (curative intent) 13 ( 2.7) 15 ( 1.0)
4 palliative (S/S relieve) 23 ( 4.8) 51 ( 3.3)
化療處方 (%) 0 No & Unknown 336 (70.3) 1146 (74.5) 0.089 0.148
1 Gemcitabine & cisplatin 39 ( 8.2) 124 ( 8.1)
2 MVAC 10 ( 2.1) 11 ( 0.7)
3 Taxans-based 0 ( 0.0) 1 ( 0.1)
4 Carboplatin-based 49 (10.3) 141 ( 9.2)
5 others 44 ( 9.2) 116 ( 7.5)
Bladder_cuff_resection (%) 0 Not perform BCR 11 ( 2.3) 46 ( 3.0) <0.001 2.195
1 Open incision 92 (19.2) 1026 (66.7)
2 Transurethral incision 9 ( 1.9) 54 ( 3.5)
4 Laparoscopy 6 ( 1.3) 303 (19.7)
5 Robot assisted 321 (67.2) 5 ( 0.3)
NA 39 ( 8.2) 105 ( 6.8)
simultaneously_ipsilateral_adrenalectomy (%) 0 No 407 (85.1) 1203 (78.2) 0.002 0.196
1 Yes 26 ( 5.4) 95 ( 6.2)
NA 45 ( 9.4) 241 (15.7)
Post_operation_intravesical_CT_instillation (%) 1 No 356 (74.5) 1366 (88.8) <0.001 0.478
2 術中膀胱灌藥 41 ( 8.6) 6 ( 0.4)
3 術後膀胱灌藥 38 ( 7.9) 50 ( 3.2)
NA 43 ( 9.0) 117 ( 7.6)
Clavien_Dindo_classification (%) 0 No Complication 284 (59.4) 900 (58.5) 0.008 0.249
1 Grade I 78 (16.3) 175 (11.4)
2 Grade II 76 (15.9) 239 (15.5)
3 Grade IIIa 4 ( 0.8) 14 ( 0.9)
4 Grade IIIb 4 ( 0.8) 21 ( 1.4)
5 Grade IVa 3 ( 0.6) 15 ( 1.0)
6 Grade IVb 0 ( 0.0) 1 ( 0.1)
7 Grade V 3 ( 0.6) 6 ( 0.4)
NA 26 ( 5.4) 168 (10.9)
Disease_free (%) 0 No 107 (22.4) 257 (16.7) <0.001 0.241
1 Yes 317 (66.3) 1084 (70.4)
3 Segmental resection 後復發或轉移 11 ( 2.3) 6 ( 0.4)
4 Unknown 43 ( 9.0) 192 (12.5)
Mortality (%) 0 No 312 (65.3) 835 (54.3) <0.001 0.342
1 UTUC related 66 (13.8) 175 (11.4)
2 Non-UTUC related 44 ( 9.2) 231 (15.0)
3 死因不明 27 ( 5.6) 203 (13.2)
4 Surgery related 2 ( 0.4) 9 ( 0.6)
5 無法判斷生死 27 ( 5.6) 86 ( 5.6)
術後住院天數_day (mean (SD)) 7.60 (4.16) 8.44 (5.68) 0.004 0.168
手術到死亡間隔時間_月 (mean (SD)) 24.10 (17.50) 38.77 (32.74) <0.001 0.559
Longest_follow_up_month_for_BDFS_DFS (mean (SD)) 31.38 (22.82) 39.23 (31.65) <0.001 0.285
Followup (mean (SD)) 48.06 (95.91) 52.79 (39.89) 0.124 0.064

1.2 missing value

2 Impute Missing Value

We utilize MICE to impute the missing value, since too much missing value.

2.1 MICE

MICE stands for Multivariate Imputation by Chained Equations. It is a statistical method used to handle missing data in a dataset. The process uses multiple imputation techniques to fill in the missing data and then combines the results from multiple imputations to produce a final imputed dataset.

\(\text{Table}\:\text{1.}\) Robot vs LPS+LESS after imputing the missing value.
Robot LPS+LESS total
N 477 1539 2016


After MICE
level 1 Robot 2 LPS+LESS p test SMD
n 477 1539
ECOG (%) 0 無症狀 255 (53.5) 736 (47.8) 0.005 0.233
1 有症狀,可步行對生活不影響 193 (40.5) 640 (41.6)
2 躺在床上時間小於50% 23 ( 4.8) 116 ( 7.5)
3 躺在床上時間大於50% 6 ( 1.3) 20 ( 1.3)
4 完全臥床 0 ( 0.0) 27 ( 1.8)
性別 (%) 1 男 202 (42.3) 633 (41.1) 0.676 0.025
2 女 275 (57.7) 906 (58.9)
BMI (%) 1 Normal 299 (62.7) 956 (62.1) 0.866 0.012
2 Overweight 178 (37.3) 583 (37.9)
Cell_Type (%) 1 urothelial 412 (86.4) 1385 (90.0) 0.074 0.115
5 UC with variants 61 (12.8) 147 ( 9.6)
6 others 4 ( 0.8) 7 ( 0.5)
左右側 (%) 1 左 248 (52.0) 800 (52.0) 0.990 0.008
2 右 222 (46.5) 715 (46.5)
3 雙側 7 ( 1.5) 24 ( 1.6)
腫瘤位置 (%) 0 non-visible 1 ( 0.2) 1 ( 0.1) 0.395 0.102
1 腎盂 186 (39.0) 652 (42.4)
2 輸尿管 175 (36.7) 499 (32.4)
3 膀胱袖口 1 ( 0.2) 2 ( 0.1)
4 多個位置 114 (23.9) 385 (25.0)
多發性 (%) 0 Not available 18 ( 3.8) 90 ( 5.8) 0.213 0.097
1 No 295 (61.8) 933 (60.6)
2 Yes 164 (34.4) 516 (33.5)
腫瘤大小 (%) 0 Not available 7 ( 1.5) 55 ( 3.6) 0.057 0.138
1 <2cm 152 (31.9) 460 (29.9)
2 >=2cm 318 (66.7) 1024 (66.5)
病理分期 (%) 1 stage 0a/0is 74 (15.5) 247 (16.0) 0.026 0.167
2 stage I 123 (25.8) 441 (28.7)
3 stage II 81 (17.0) 301 (19.6)
4 stage III 146 (30.6) 444 (28.8)
5 stage IV 53 (11.1) 106 ( 6.9)
完整檢體腫瘤惡性度 (%) 1 papillary urothelial neoplasm of low malignant potential 1 ( 0.2) 1 ( 0.1) 0.780 0.049
2 low grade 47 ( 9.9) 140 ( 9.1)
3 high grade 425 (89.1) 1383 (89.9)
4 Gx 4 ( 0.8) 15 ( 1.0)
合併膀胱腫瘤 (%) 0 No 359 (75.3) 1115 (72.4) 0.600 0.073
1 Previous Hx of bladder UC 33 ( 6.9) 117 ( 7.6)
2 Concurrent Bladder UC 71 (14.9) 265 (17.2)
3 Not available 14 ( 2.9) 42 ( 2.7)
合併CIS (%) 0 No 329 (69.0) 1091 (70.9) 0.457 0.042
1 Yes 148 (31.0) 448 (29.1)
Lymphovascular_invasion (%) 0 No 384 (80.5) 1269 (82.5) 0.367 0.050
1 Yes 93 (19.5) 270 (17.5)
surgical_margin (%) 0 Free 450 (94.3) 1488 (96.7) 0.029 0.114
1 Positive 27 ( 5.7) 51 ( 3.3)
術前水腎 (%) 0 No 214 (44.9) 757 (49.2) 0.110 0.087
1 Yes 263 (55.1) 782 (50.8)
Tumor_Necrosis (%) 0 No 420 (88.1) 1267 (82.3) 0.004 0.162
1 Yes 57 (11.9) 272 (17.7)
有無針對UTUC化療 (%) 0 No 320 (67.1) 1071 (69.6) 0.019 0.154
1 Yes 147 (30.8) 402 (26.1)
2 Not available 10 ( 2.1) 66 ( 4.3)
針對UTUC化療型態 (%) 0 No & Unknown 330 (69.2) 1135 (73.7) 0.010 0.173
1 neo-adjuvant 19 ( 4.0) 42 ( 2.7)
2 adjuvant 92 (19.3) 296 (19.2)
3 salvage (curative intent) 13 ( 2.7) 15 ( 1.0)
4 palliative (S/S relieve) 23 ( 4.8) 51 ( 3.3)
化療處方 (%) 0 No & Unknown 335 (70.2) 1146 (74.5) 0.049 0.148
1 Gemcitabine & cisplatin 39 ( 8.2) 124 ( 8.1)
2 MVAC 10 ( 2.1) 11 ( 0.7)
3 Taxans-based 0 ( 0.0) 1 ( 0.1)
5 others 93 (19.5) 257 (16.7)
Bladder_cuff_resection (%) 0 Not perform BCR 13 ( 2.7) 55 ( 3.6) <0.001 2.296
1 Open incision 103 (21.6) 1084 (70.4)
2 Transurethral incision 10 ( 2.1) 62 ( 4.0)
4 Laparoscopy 9 ( 1.9) 332 (21.6)
5 Robot assisted 342 (71.7) 6 ( 0.4)
simultaneously_ipsilateral_adrenalectomy (%) 0 No 443 (92.9) 1409 (91.6) 0.409 0.049
1 Yes 34 ( 7.1) 130 ( 8.4)
Post_operation_intravesical_CT_instillation (%) 0 No 392 (82.2) 1463 (95.1) <0.001 0.452
1 術中膀胱灌藥 43 ( 9.0) 10 ( 0.6)
2 術後膀胱灌藥 42 ( 8.8) 66 ( 4.3)
診斷年紀 (mean (SD)) 69.28 (10.25) 68.75 (10.48) 0.330 0.051
Clavien_Dindo_classification (%) 0 No Complication 298 (62.5) 990 (64.3) 0.430 0.140
1 Grade I 80 (16.8) 201 (13.1)
2 Grade II 81 (17.0) 267 (17.3)
3 Grade IIIa 4 ( 0.8) 19 ( 1.2)
4 Grade IIIb 5 ( 1.0) 26 ( 1.7)
5 Grade IVa 3 ( 0.6) 17 ( 1.1)
6 Grade IVb 1 ( 0.2) 7 ( 0.5)
7 Grade V 5 ( 1.0) 12 ( 0.8)
Disease_free (%) 0 No 107 (22.4) 257 (16.7) 0.006 0.145
1 Yes 370 (77.6) 1282 (83.3)
Mortality (%) 0 No 311 (65.2) 835 (54.3) <0.001 0.225
1 Yes 166 (34.8) 704 (45.7)
術後住院天數_day (mean (SD)) 7.58 (4.12) 8.52 (5.69) 0.001 0.189
Followup (mean (SD)) 43.72 (30.89) 52.39 (39.77) <0.001 0.243
Followup_DF (mean (SD)) 31.36 (22.77) 39.07 (31.54) <0.001 0.280

3 Overlap weighting

After

after overlap weighting
level 1 Robot 2 LPS+LESS p test SMD
n 478.0 1539.0
Clavien_Dindo_classification (%) 0 No Complication 267.9 (56.0) 964.0 (62.6) 0.419 0.217
1 Grade I 78.0 (16.3) 207.0 (13.5)
2 Grade II 107.6 (22.5) 298.2 (19.4)
3 Grade IIIa 9.0 ( 1.9) 17.0 ( 1.1)
4 Grade IIIb 11.4 ( 2.4) 25.9 ( 1.7)
5 Grade IVa 0.1 ( 0.0) 14.2 ( 0.9)
6 Grade IVb 3.6 ( 0.7) 6.3 ( 0.4)
7 Grade V 0.5 ( 0.1) 6.3 ( 0.4)
Disease_free (%) 0 No 91.6 (19.2) 288.1 (18.7) <0.001 0.308
1 Yes 325.0 (68.0) 1077.5 (70.0)
3 Segmental resection 後復發或轉移 23.8 ( 5.0) 4.9 ( 0.3)
4 Unknown 37.7 ( 7.9) 168.5 (11.0)
Mortality (%) 0 No 304.8 (63.8) 870.9 (56.6) 0.115 0.147
1 Yes 173.2 (36.2) 668.1 (43.4)
術後住院天數_day (mean (SD)) 7.23 (3.36) 8.17 (5.36) 0.005 0.210

Before

before overlap weighting
level 1 Robot 2 LPS+LESS p test SMD
n 477 1539
Clavien_Dindo_classification (%) 0 No Complication 298 (62.5) 990 (64.3) 0.430 0.140
1 Grade I 80 (16.8) 201 (13.1)
2 Grade II 81 (17.0) 267 (17.3)
3 Grade IIIa 4 ( 0.8) 19 ( 1.2)
4 Grade IIIb 5 ( 1.0) 26 ( 1.7)
5 Grade IVa 3 ( 0.6) 17 ( 1.1)
6 Grade IVb 1 ( 0.2) 7 ( 0.5)
7 Grade V 5 ( 1.0) 12 ( 0.8)
Disease_free (%) 0 No 107 (22.4) 257 (16.7) 0.006 0.145
1 Yes 370 (77.6) 1282 (83.3)
Mortality (%) 0 No 311 (65.2) 835 (54.3) <0.001 0.225
1 Yes 166 (34.8) 704 (45.7)
術後住院天數_day (mean (SD)) 7.58 (4.12) 8.52 (5.69) 0.001 0.189

4 Modeling

p-value

coef

5 Survival Curve

OS

DFS